DR. THEODORE P ROMAN (NPI# 1659518983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659518983 |
| Entity Type | Individual |
| Full Name | DR. THEODORE P ROMAN |
| Credential | MD |
| Practice Address |
317 Main Street Eagle Butte SD 57625 |
| Mailing Address |
Po Box 1012 Eagle Butte SD 57625-1012 |
| Practice Telephone | 6059643007 |
| Practice Fax Number | 6059641139 |
| Mailing Telephone | 6059643007 |
| Mailing Fax Number | 6059641139 |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0527 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | SD PHYSICIAN LICENSE | 0527 | 01 |
| Street Address |
317 MAIN STREET |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386920411 | Susan Ashley Fuller | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625 | 2011-11-03 |
| 1922380534 | Jessi Marri Steve | Nurse Practitioner | 317 Main Street, Eagle Butte, SD 57625 | 2011-09-10 |
| 1952604944 | Saomony Cheam | Pharmacist | 317 Main Street, Eagle Butte, SD 57625 | 2010-12-13 |
| 1801198585 | Randi Peacock | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625-1012 | 2010-12-01 |
| 1023318953 | Heather Leigh Martin | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625 | 2010-10-26 |
| 1023327780 | Candace Mae Veit | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625 | 2010-09-29 |
| 1801121702 | Danette Darlene Serr | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625 | 2009-10-09 |
| 1558590091 | Jonni A Rousseau | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625-0000 | 2009-07-06 |
| 1770778821 | Eunice Rose Montreal | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625-0326 | 2007-09-12 |
| 1003028598 | Rikki Rae Fasthorse | Registered Nurse | 317 Main Street, Eagle Butte, SD 57625-1012 | 2007-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
| 1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
| 1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
| 1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
| 1922452531 | Holly Mattern | Registered Nurse | 24276 166th Street Airport Rd, Eagle Bute, SD 57625 | 2016-04-20 |
| Find all providers in zip 57625 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043284714 | Margaret L Upell | Family Medicine | 315 Main Street, Eagle Butte, SD 57625-0000 | 2006-02-17 |
| 1447369541 | Mark Marian Witoszka | Family Medicine | 317 Main St, Eagle Butte, SD 57625-1012 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343505 | Kaitlyn Mae Fritz | Family Medicine | Wellness Center 103, Brookings, SD 57007-0001 | 2020-10-12 |
| 1447877386 | Black Hills Primary Care PC | Family Medicine | 8075 Stage Stop Rd., Summerset, SD 57718 | 2020-06-26 |
| 1467003251 | Arthur Lampert | Family Medicine | 1770 Tablerock Rd Apt 120, Rapid City, SD 57701-5586 | 2019-09-24 |
| 1851883540 | Modern Day Health Care Prof LLC | Family Medicine | 125 Railroad Ave Se, Aberdeen, SD 57401-4202 | 2018-05-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1023524741 | Quick Health Urgent Care LLC | Family Medicine | 7600 S Louise Ave Ste 150, Sioux Falls, SD 57108-5999 | 2017-12-18 |
| 1568991446 | Callie Pederson | Family Medicine | 28th Medical Group, 2900 Doolitle Drive, Ellsworth Afb, SD 57706-4821 | 2017-06-05 |
| 1144751256 | Maya Itza Koehler | Family Medicine | 534 Oregon Ave Se, Huron, SD 57350-2801 | 2017-03-22 |
| 1578004883 | Sacred Heart Health Services | Family Medicine | 2525 Fox Run Pkwy Ste 200, Yankton, SD 57078-5371 | 2017-03-20 |
| 1073992004 | Monument Health Network, Inc. | Family Medicine | 209 Ramsland St, Buffalo, SD 57720-0045 | 2015-05-22 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE BUTTE |
| Zip Code | 57625 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.